摘要
目的:分析高血压脑出血(HICH)患者术后发生脑积水(HCP)的影响因素,并探讨相应的干预对策。方法:回顾性分析2021年6月—2023年12月于三明市第一医院进行血肿清除手术治疗的172例HICH患者的临床资料,根据术后有无发生HCP划分为HCP组和非HCP组。采用单因素分析与logistic回归分析影响HICH患者术后发生HCP的独立影响因素,受试者工作特征曲线(ROC)分析相关独立影响因素的最佳截断值。结果:172例HICH患者中,42例(24.4%)术后出现HCP。两组高血压病程、血肿体积、血肿破入脑室、术前格拉斯哥昏迷评分(GCS)、修正型Graeb评分(mGS)、肠内营养时机及合并颅内感染情况比较,差异有统计学意义(P<0.05)。logistic回归分析结果显示,高血压病程、血肿破入脑室、术前GCS、术前mGS、肠内营养时机及合并颅内感染均为HICH患者发生HCP的独立影响因素(P<0.05)。ROC分析结果显示,高血压病程、术前GCS和mGS的截断值分别为6.5年、8.5分和7.5分。结论:高血压病程、术前GCS、mGS、合并颅内感染、肠内营养延迟及血肿破入脑室是HICH患者术后发生HCP的独立影响因素,应针对相关影响因素早期识别和管理高风险患者,采取针对性干预措施,以减少HCP发生。
Objective:To analyze the influencing factors of postoperative hydrocephalus(HCP)in patients with hypertensive intracerebral hemorrhage(HICH),and to explore the corresponding intervention strategies.Method:The clinical data of 172 HICH patients who underwent hematoma removal surgery in Sanming First Hospital from June 2021 to December 2023 were retrospectively analyzed,they were divided into HCP group and non-HCP group according to the presence or absence of HCP after surgery.Univariate analysis and logistic regression analysis were used to analyze the independent influencing factors of postoperative HCP in HICH patients,and receiver operating characteristic curve(ROC)analysis was used to analyze the optimal cut-off values of related independent influencing factors.Result:Among 172 HICH patients,42 cases(24.4%)had postoperative HCP.There were significant differences in the hypertension course,hematoma volume,hematoma breaking into ventricles,preoperative Glasgow coma score(GCS),modified Graeb score(mGS),timing of enteral nutrition and intracranial infection between two groups(P<0.05).logistic regression analysis showed that the hypertension course,hematoma breaking into ventricles,preoperative GCS,preoperative mGS,timing of enteral nutrition and intracranial infection were independent influencing factors of HCP in HICH patients(P<0.05).ROC analysis showed that the cut-off values of hypertension course,preoperative GCS and mGS were 6.5 years,8.5 scores and 7.5 scores,respectively.Conclusion:Hypertension course,preoperative GCS,mGS,concurrent intracranial infection,delayed enteral nutrition and hematoma breaking into ventricles are independent influencing factors for postoperative HCP in HICH patients,early identification and management of high-risk patients based on relevant risk factors should be carried out,and targeted intervention measures should be taken to reduce the occurrence of HCP.
作者
李舟咏
苏千淇
李小红
LI Zhouyong;SU Qianqi;LI Xiaohong(Sanming First Hospital,Sanming 365000,China;不详)
出处
《中外医学研究》
2024年第26期169-172,共4页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
高血压脑出血
脑积水
影响因素
干预对策
Hypertensive intracerebral hemorrhage
Hydrocephalus
Influencing factors
Intervention countermeasures
